Provider Demographics
NPI:1629092762
Name:ALBERT, BRIAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:H
Last Name:ALBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 W RAND RD
Mailing Address - Street 2:
Mailing Address - City:MT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-1151
Mailing Address - Country:US
Mailing Address - Phone:847-725-8401
Mailing Address - Fax:847-618-5459
Practice Address - Street 1:199 W RAND RD
Practice Address - Street 2:
Practice Address - City:MT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-1151
Practice Address - Country:US
Practice Address - Phone:847-725-8401
Practice Address - Fax:847-618-5459
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036071342207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036071342Medicaid